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Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Hyperthyroidism I: Introduction

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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Graves Disease II: Pathophysiology

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Graves' Disease I: Introduction

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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

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Related Experiment Video

Updated: Jun 19, 2026

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Published on: September 20, 2024

Is total thyroidectomy justified in multinodular goitre.

R Riju¹, Santosh Jadhav, Rajasekhar Kanthaswamy

¹Department of General and Endocrine Surgery, Amrita Institute of Medical Sciences, Kochi 682026.

Journal of the Indian Medical Association

|October 9, 2009

Summary

Total thyroidectomy is a safe option for benign thyroid diseases, showing complication rates similar to subtotal thyroidectomy. This surgical approach is acceptable, especially for recurrent goiters, minimizing postoperative morbidity.

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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Published on: September 15, 2023

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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

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Published on: September 20, 2024

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Area of Science:

Endocrinology
Surgical Oncology
Thyroid Surgery

Background:

The role of total thyroidectomy versus subtotal thyroidectomy for benign thyroid diseases is debated.
This study investigates complication rates and outcomes for both procedures in benign thyroid conditions.

Purpose of the Study:

To compare the rates of immediate and late complications between total thyroidectomy and subtotal thyroidectomy for benign thyroid diseases.
To evaluate the safety and efficacy of total thyroidectomy as an alternative surgical option.

Main Methods:

A retrospective case-control study analyzing 189 patients with benign thyroid diseases operated between May 2002 and September 2004.
Patients underwent either total thyroidectomy (94) or subtotal thyroidectomy (95) with a minimum 3-year follow-up.

Main Results:

No permanent recurrent laryngeal nerve paralysis occurred in either group.
Temporary unilateral recurrent laryngeal nerve paralysis was slightly higher in the total thyroidectomy group (3.2%) versus subtotal (1.1%), not statistically significant (p=0.307).
Temporary hypocalcemia was observed in 10.6% of total thyroidectomy patients and 3.2% of subtotal thyroidectomy patients. Permanent hypocalcemia rates were similar (2 patients each).

Conclusions:

Total thyroidectomy is an acceptable alternative to subtotal thyroidectomy for benign thyroid diseases.
The study supports total thyroidectomy, particularly in cases of recurrent goiters, due to potentially lower postoperative morbidity.